7 ms·

Coronavirus Mortality Rate

103 points by rgbrgb 7y ago

WheelsAtLarge 7y ago
I'm not an expert by any means but I suspect that the Mortality rate is lower than what they have said. We've been told that the majority of people will get very mild symptoms if they have it. So the actual number of people that have been infected is way higher since many will never even think of going to a doctor. So the 2-3% case fatality rate is higher than the actual number. If the number of deaths is correct or close to correct. The scary part is that the virus is so easily spread between humans so the number of deaths will skyrocket when compared to other epidemics. Let's hope they bring it under control soon and there's a vaccine in the near future.
- narrator 7y ago
  The scary part is "acute cardiac injury" being a frequent complication. The virus causes heart attacks! https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... "Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died."
  - kayoone 7y ago
    (from the article) 80% of people who died were over 60 years old and 75% had underlying health conditions including cardiovascular problems, so the fact that the virus caused fatal cardiovascular events in some of those cases is not unexpected.
    - lazyasciiart 7y ago
      About 80% of Americans over 60 have cardiovascular problems, compared to a third of elderly Chinese people. That stat indicates that fatality rates could be higher in the US (and other western countries, although I don't have those numbers immediately) than China. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_483970.pdf https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd... https://www.jwatch.org/na48562/2019/03/05/china-cardiovascular-epidemic-warning-bell https://www.jwatch.org/na48562/2019/03/05/china-cardiovascul...
  - azalemeth 7y ago
    Believe it or not, this can happen infrequently with "ordinary" viruses: viral myocarditis (inflammation and infection of the heart muscle) is an under-appreciated killer of the young, with a mortality rate of between 25-50% [1] and is a well-known complication of, for example, influenza [2]. In fact, it's believed that myocarditis was involved in as much as 50% of Spanish flu fatalities in the early part of the 20th century. The difference is that if you're young and healthy, you're likely to clear infections well before they get to the point of systemically infecting each organ. In the population of those who are acutely unwell with this novel virus, you have to remember that there is a massive selection bias for those hospital doctors to see the sickest people. Myocarditis is unfortunately one of those things that is therefore probably to some degree expected. The real question is "what is the probability that you end up in this terrible situation given you are infected with coronavirus" -- and in order to do that, you need a good estimate of how many people have been infected (but not died or seriously ill!) with the novel coronavirus. This is very hard to do in Wuhan, and estimates vary by orders of magnitude. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370379/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370379/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533457/
  - yread 7y ago
    These are from earlier small scale studies, I believe this study has much larger cohort (1000+ patients) https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v1 https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v...
- streetcat1 7y ago
  The problem here will not be the virus, but the healthcare system capacity (I.e. the hospitals capacity). I.e. If you managed to get care, the mortality rate is X, but without care, it is 10X or even more. So to judge the current mortality rate, you have to know how many of the infected received care. I also assume that hospitals are like the phone system. I.e. they do not expect mass load at the same time.
  - WheelsAtLarge 7y ago
    That would be a very valuable number. What is the actual number of people that need to be hospitalized for this virus vs other epidemics?
    - streetcat1 7y ago
      Based on what I read (mainly a very good analysis of first patient in the US), I think 100%, as everyone would need oxygen, as the virus infect the lungs (even with no preconditions). And this is on a healthy, young patient. https://www.nejm.org/doi/full/10.1056/NEJMoa2001191 https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
      - jacobolus 7y ago
        No, not everyone who contracts this virus ends up with pneumonia and needing a respirator. But it’s still a sufficient proportion to serve as a denial-of-service attack on hospitals, if the virus spreads throughout the community.
deleted 7y ago
[deleted]
tylerjwilk00 7y ago
The TL;DR; Initial estimates of mortality rate are all over the place due to uncertainty in the data sets. That said, the best estimate at the moment is around 2-3% and is subject to change as more data comes in.
- anonsivalley652 7y ago
  Yes. By comparison: --- Mortality rate --- 1918 Spanish Flu: 10-20% 2020 Coronavirus: 2-3% est. 1968 Hong Kong Flu: 0.5% -------- The realization that China censors heavily makes both accurate, timely and complete reporting of facts much more difficult. Intermediaries are used to exfil data to Western journalists, but this is haphazard, slow and incomplete. A journalist who has contacts on the ground described the situation, including that a few bodies on the streets and in crashed vehicles (people who were too sick who failed to make it to a hospital) in central Wuhan were not being collected: https://www.democracynow.org/2020/2/7/laurie_garrett_china_coronavirus_response https://www.democracynow.org/2020/2/7/laurie_garrett_china_c... We may never know the exact numbers because it's likely face-saving deception will be used for geopolitical and local political concerns.
  - themagician 7y ago
    I was looking up the current flu season in the US here: https://www.cdc.gov/flu/weekly/index.htm https://www.cdc.gov/flu/weekly/index.htm It says the mortality rate is 7.1%. Does that make the current flu in the US much worse than the Coronavirus?
    - deleted 7y ago
      [deleted]
    - ce4 7y ago
      That's not the mortality rate but the ratio against overall deaths. it says: "The percentage of deaths attributed to pneumonia and influenza is 7.1%, below the epidemic threshold of 7.2%."
      - 7y ago
fctorial 7y ago
The mortality rate, as calculated by trivial formula, has stayed close to 2% for a couple of weeks now.
not_a_moth 7y ago
Watching this closely based in Singapore, the true mortality rate is probably an order of magnitude lower a) The stats coming from Hubei are adverse selected; they are from patients who already had severe enough illness to go to the hospital b) A vast amount of mild cases are not diagnosed or tested, this is for reasons related to self reporting and minimal screening efforts globally c) The virus spreads rapidly (R0 of 4 in some estimates) and has had 3 months to sweep through Wuhan ; there appears to be a lot of death in Wuhan but that may be because most of the 11 million population was exposed Maybe I'm confirming a bias, but I believe its true profile is something like a more rapidly moving seasonal flu
- lazyasciiart 7y ago
  They're also selected for people who made it to a hospital. The most frail types, or those who got sick after hospitals were filling up, could have died without ever getting to a hospital, and not even be counted yet.
  - not_a_moth 7y ago
    Agreed but even if you think the real Wuhan death count is 10x the official (ie. ~10K deaths in Wuhan), there's still an order of magnitude lower mortality rate assuming there's been widespread exposure in the 3 months
    - cameldrv 7y ago
      We don’t know the actual death toll in Wuhan. The number we get is people who were diagnosed and then were determined to have died of the disease. What we’d really like to know is simply how many people have died of any cause, and then subtract a base rate. The total deaths figure is not being provided.
- heavyset_go 7y ago
  > a) The stats coming from Hubei are adverse selected; they are from patients who already had severe enough illness to go to the hospital I don't think this assumption holds true. In a panic, many people are trying to get diagnosed based on rightfully held fear. These are people who have the energy to travel to many hospitals and stand in lines for hours. In some places, people who are seemingly symptomatic are also encouraged/forced to be diagnosed despite not feeling the need to go to a hospital.
mirimir 7y ago
The more I read about this, the more I wonder about the reliability of mortality rates generally. Or at least, for diseases where diagnosis depends on DNA-based testing. I mean, it seems likely that pretty much everyone who dies will be tested. Except for victims of auto accidents or whatever. But it also seems likely that many with minimal symptoms won't be tested. Perhaps because hospitals are so busy that people can't be bothered. Or maybe because people are afraid of hospitals, because they're full of sick people. Or simply because there's inadequate testing capability. So isn't it likely that mortality will always be overestimated for such specific diseases? As opposed to, for example, auto accidents or falls.
- swsieber 7y ago
  From what I've read it's highly unlikely the dead will be tested. Just cremate them and move on. At least, that's what it seems like with all the tales of death certificates with cause of death as "Unknown viral pneumonia"
  - lostlogin 7y ago
    > From what I've read it's highly unlikely the dead will be tested. Not only that, but are the Chinese authorities going to accurately report that numbers?
    - n0rbwah 7y ago
      At this point, I'm not sure to see any reason for them to lie about it except for the force of habit.
      - DuskStar 7y ago
        Another reason would be that on a day-to-day basis it's easier to say "yeah we had 100 deaths yesterday" than it is to say "we've been lying, there were 1,000 deaths yesterday and 10,000 so far with 500,000 infected in Wuhan by our estimates". Which would probably also cause a wee bit of panic, too. If that's actually the case, of course.
wyattpeak 7y ago
A lot of discussion seems to highlight the problem of unreported cases, but surely this is a problem for all diseases, not just novel ones. Are there any epidemiologists here to answer how we account for unreported cases of e.g. flu in mortality rates? And if we don't, is it reasonable to ignore unreported cases of coronavirus as well, to compare like with like, or is there some factor I'm missing?
- yibg 7y ago
  Not an expert here but isn’t there an unknown in the ratio of reported cases too? I doubt it’s safe to assume the percentage of flu cases reported is anywhere close to that of publicized viruses.
- Maxion 7y ago
  That is correct, though I'm not an epidemiologist. The number is estimated using statistical models, such as SEIR and others. http://www.public.asu.edu/~hnesse/classes/seir.html http://www.public.asu.edu/~hnesse/classes/seir.html
mrtksn 7y ago
Okay, I have been following this closely as I follow JS libraries and this is the headline: The virus seems to require intensive care to some subset of the infected people and deaths occur when that care is not given in timely manner. That means it's mortality rate increases dramatically when your patient care infrastructure gets saturated.
- beamatronic 7y ago
  Eloquently put. Agree 100%. The logical conclusion then is to ramp up your patient care infrastructure proactively: identity and clear the bottlenecks.
  - reagent_finder 7y ago
    Or just cut the budgets.
  - FPGAhacker 7y ago
    Agreed. It seems to me there are, in the main, two problems which include many other problems relating to the general problem.
  - koheripbal 7y ago
    The bottleneck is the number of mechanical ventilators available. Ideally we want someone on a ventilator to be in an ICU and under a doctor's supervision, but in a crisis you can put a ventilator anywhere. A patient with COVID-19, will likely spend about 2 weeks on a ventilator. Unfortunately, there are only about 60-70,000 mechanical ventilators in the entire US (and maybe double that if you include older less automated ones), and about half of them are for neonatal wards. [source](https://www.ncbi.nlm.nih.gov/pubmed/21149215 https://www.ncbi.nlm.nih.gov/pubmed/21149215). 10% of COVID-19 infections require mechanical ventilation. [source](https://clinicaltrials.gov/ct2/show/record/NCT04244591 https://clinicaltrials.gov/ct2/show/record/NCT04244591). This means that if the US encountered an outbreak on the scale of what is happening in China, then we would also quickly run out of ventilators, and the mortality rate would be 2-4x what it would be otherwise, rather than the 1-2% mortality rate everyone is expecting.
anonsivalley652 7y ago
It's interesting that MERS was about twice as deadly as the Spanish Flu. I guess because it happened in a certain part of the world, the Western media just decided it wasn't worthy of wall-to-wall Snowpocalypse yellow journalism.
- dragonwriter 7y ago
  Threat from a disease is a combination of tendency to spread, circumstance of initial outbreak, and deadliness. The latter alone isn't what makes it a matter of urgent global concern on a simple pragmatic level.
  - anonsivalley652 7y ago
    That's obvious. It's more contagious than Ebola but less so than Norovirus. You're discounting that MERS hasn't gone away... it's sitting in reservoir(s) of wild and/or domesticated animals right now, likely on two continents thanks to travel and clusters of human cases in South Korea as well. If that doesn't worry you, then I guess anticipation isn't your strong suit. The point is: hantavirus was a rare disease but was hyped up in North America, MERS is much worse and has the potential to be a minor Ebola again and again.
- occamrazor 7y ago
  MERS had apparently a low infectivity, making it a low level threat to the rest of the world.
  - anonsivalley652 7y ago
    It's difficult to say that because it was still transmitted to people more easily than Ebola. And the data and research show MERS isn't going away; bats maybe its natural reservoir. Pretending it doesn't exist or not doing anything about is playing Russian roulette with public health. If the US Army Corps of Engineers can eliminate malaria from the southern US, maybe a vaccine can be developed for the natural host and domesticated animals to prevent the risk to humans.
christkv 7y ago
The ongoing nightmare of the cruise ship in japan will provide a worst case unbiased example not tainted by the reliability of Chinese reporting. I just hope that most of them will escape what looks to me like my personal nightmare.
- koheripbal 7y ago
  Agreed. The quarantined cruise ship is, sadly, an excellent inadvertent experiment for us. It won't help much with the R0 calculation, but it will give us a good idea for mortality, though it might take 3 weeks to get that number.
fxj 7y ago
For "realtime" numbers there is a chinese web-page which shows the mortality rate is of the order 2% and the new infections in Hubei are decreasing. (Google translate is your friend.) https://ncov.dxy.cn/ncovh5/view/pneumonia https://ncov.dxy.cn/ncovh5/view/pneumonia
blackrock 7y ago
The initial death rates were shocking. The reproduction R0 number seemed high. This was a very contagious virus. The world went into a panic. And rumors, conspiracy theories, and bad science didn’t help (the German and Indian papers). But what was really behind the numbers. Was it old people that were dying? Was it middle aged and young people? Was this some kind of stealthy virus that creeps up on you, and then just kills you? It’s possible that it was a lack of medical facilities and equipment, that contributed to the crisis, and thus, contributed to the high initial death rates. For example, when people started getting sick. The first batch went to the ICU, and took up available beds and medical facilities. These people had the highest chance of surviving. But then, the next wave came in and created the beginning of the crisis, and swamped the system. Then, the third wave came in and totally overwhelmed the system, that the hospitals couldn’t help them at all. They were turned away, and left to fend for themselves. These people started dying in their homes. The system suffered such a massive denial of service attack, that it was impossible to help and provide service to everyone. Thus this created the shockingly high mortality rate during the initial days of the crisis. If we are lucky, then this might remain true. So in other parts of the world with more medical facilities, knowing this might save people, and give them a higher chance of surviving this virus. Stay strong, Wuhan! Wuhan, Jaiyou!
jpizagno 7y ago
Does this website not look a little suspicious ? It is hard to find an actual name of a person behind this site. When I go to faq -> "Who .." there is another company called "Dadax" listed, but no link. odd I am asking because people have sent me other suspicious sites over the last few weeks (wuflu.live). I am not denying the virus, just questioning things on the internet.
- koheripbal 7y ago
  I am loath to use my real name on absolutely anything I put online. ...and frankly, I do not understand people that do. There are crazy people on the internet, and many of them love to hold a grudge.
- deleted 7y ago
  [deleted]

103 points by rgbrgb 7y ago

I'm not an expert by any means but I suspect that the Mortality rate is lower than what they have said. We've been told that the majority of people will get very mild symptoms if they have it. So the actual number of people that have been infected is way higher since many will never even think of going to a doctor. So the 2-3% case fatality rate is higher than the actual number. If the number of deaths is correct or close to correct. The scary part is that the virus is so easily spread between humans so the number of deaths will skyrocket when compared to other epidemics. Let's hope they bring it under control soon and there's a vaccine in the near future.

narrator 7y ago
The scary part is "acute cardiac injury" being a frequent complication. The virus causes heart attacks! https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... "Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died."
- kayoone 7y ago
  (from the article) 80% of people who died were over 60 years old and 75% had underlying health conditions including cardiovascular problems, so the fact that the virus caused fatal cardiovascular events in some of those cases is not unexpected.
  - lazyasciiart 7y ago
    About 80% of Americans over 60 have cardiovascular problems, compared to a third of elderly Chinese people. That stat indicates that fatality rates could be higher in the US (and other western countries, although I don't have those numbers immediately) than China. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_483970.pdf https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd... https://www.jwatch.org/na48562/2019/03/05/china-cardiovascular-epidemic-warning-bell https://www.jwatch.org/na48562/2019/03/05/china-cardiovascul...
- azalemeth 7y ago
  Believe it or not, this can happen infrequently with "ordinary" viruses: viral myocarditis (inflammation and infection of the heart muscle) is an under-appreciated killer of the young, with a mortality rate of between 25-50% [1] and is a well-known complication of, for example, influenza [2]. In fact, it's believed that myocarditis was involved in as much as 50% of Spanish flu fatalities in the early part of the 20th century. The difference is that if you're young and healthy, you're likely to clear infections well before they get to the point of systemically infecting each organ. In the population of those who are acutely unwell with this novel virus, you have to remember that there is a massive selection bias for those hospital doctors to see the sickest people. Myocarditis is unfortunately one of those things that is therefore probably to some degree expected. The real question is "what is the probability that you end up in this terrible situation given you are infected with coronavirus" -- and in order to do that, you need a good estimate of how many people have been infected (but not died or seriously ill!) with the novel coronavirus. This is very hard to do in Wuhan, and estimates vary by orders of magnitude. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370379/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370379/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533457/
- yread 7y ago
  These are from earlier small scale studies, I believe this study has much larger cohort (1000+ patients) https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v1 https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v...
streetcat1 7y ago
The problem here will not be the virus, but the healthcare system capacity (I.e. the hospitals capacity). I.e. If you managed to get care, the mortality rate is X, but without care, it is 10X or even more. So to judge the current mortality rate, you have to know how many of the infected received care. I also assume that hospitals are like the phone system. I.e. they do not expect mass load at the same time.
- WheelsAtLarge 7y ago
  That would be a very valuable number. What is the actual number of people that need to be hospitalized for this virus vs other epidemics?
  - streetcat1 7y ago
    Based on what I read (mainly a very good analysis of first patient in the US), I think 100%, as everyone would need oxygen, as the virus infect the lungs (even with no preconditions). And this is on a healthy, young patient. https://www.nejm.org/doi/full/10.1056/NEJMoa2001191 https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
    - jacobolus 7y ago
      No, not everyone who contracts this virus ends up with pneumonia and needing a respirator. But it’s still a sufficient proportion to serve as a denial-of-service attack on hospitals, if the virus spreads throughout the community.

deleted 7y ago

[deleted]

tylerjwilk00 7y ago

The TL;DR; Initial estimates of mortality rate are all over the place due to uncertainty in the data sets. That said, the best estimate at the moment is around 2-3% and is subject to change as more data comes in.

anonsivalley652 7y ago
Yes. By comparison: --- Mortality rate --- 1918 Spanish Flu: 10-20% 2020 Coronavirus: 2-3% est. 1968 Hong Kong Flu: 0.5% -------- The realization that China censors heavily makes both accurate, timely and complete reporting of facts much more difficult. Intermediaries are used to exfil data to Western journalists, but this is haphazard, slow and incomplete. A journalist who has contacts on the ground described the situation, including that a few bodies on the streets and in crashed vehicles (people who were too sick who failed to make it to a hospital) in central Wuhan were not being collected: https://www.democracynow.org/2020/2/7/laurie_garrett_china_coronavirus_response https://www.democracynow.org/2020/2/7/laurie_garrett_china_c... We may never know the exact numbers because it's likely face-saving deception will be used for geopolitical and local political concerns.
- themagician 7y ago
  I was looking up the current flu season in the US here: https://www.cdc.gov/flu/weekly/index.htm https://www.cdc.gov/flu/weekly/index.htm It says the mortality rate is 7.1%. Does that make the current flu in the US much worse than the Coronavirus?
  - deleted 7y ago
    [deleted]
  - ce4 7y ago
    That's not the mortality rate but the ratio against overall deaths. it says: "The percentage of deaths attributed to pneumonia and influenza is 7.1%, below the epidemic threshold of 7.2%."
    - 7y ago

fctorial 7y ago

The mortality rate, as calculated by trivial formula, has stayed close to 2% for a couple of weeks now.

not_a_moth 7y ago

Watching this closely based in Singapore, the true mortality rate is probably an order of magnitude lower a) The stats coming from Hubei are adverse selected; they are from patients who already had severe enough illness to go to the hospital b) A vast amount of mild cases are not diagnosed or tested, this is for reasons related to self reporting and minimal screening efforts globally c) The virus spreads rapidly (R0 of 4 in some estimates) and has had 3 months to sweep through Wuhan ; there appears to be a lot of death in Wuhan but that may be because most of the 11 million population was exposed Maybe I'm confirming a bias, but I believe its true profile is something like a more rapidly moving seasonal flu

lazyasciiart 7y ago
They're also selected for people who made it to a hospital. The most frail types, or those who got sick after hospitals were filling up, could have died without ever getting to a hospital, and not even be counted yet.
- not_a_moth 7y ago
  Agreed but even if you think the real Wuhan death count is 10x the official (ie. ~10K deaths in Wuhan), there's still an order of magnitude lower mortality rate assuming there's been widespread exposure in the 3 months
  - cameldrv 7y ago
    We don’t know the actual death toll in Wuhan. The number we get is people who were diagnosed and then were determined to have died of the disease. What we’d really like to know is simply how many people have died of any cause, and then subtract a base rate. The total deaths figure is not being provided.
heavyset_go 7y ago
> a) The stats coming from Hubei are adverse selected; they are from patients who already had severe enough illness to go to the hospital I don't think this assumption holds true. In a panic, many people are trying to get diagnosed based on rightfully held fear. These are people who have the energy to travel to many hospitals and stand in lines for hours. In some places, people who are seemingly symptomatic are also encouraged/forced to be diagnosed despite not feeling the need to go to a hospital.

mirimir 7y ago

The more I read about this, the more I wonder about the reliability of mortality rates generally. Or at least, for diseases where diagnosis depends on DNA-based testing. I mean, it seems likely that pretty much everyone who dies will be tested. Except for victims of auto accidents or whatever. But it also seems likely that many with minimal symptoms won't be tested. Perhaps because hospitals are so busy that people can't be bothered. Or maybe because people are afraid of hospitals, because they're full of sick people. Or simply because there's inadequate testing capability. So isn't it likely that mortality will always be overestimated for such specific diseases? As opposed to, for example, auto accidents or falls.

swsieber 7y ago
From what I've read it's highly unlikely the dead will be tested. Just cremate them and move on. At least, that's what it seems like with all the tales of death certificates with cause of death as "Unknown viral pneumonia"
- lostlogin 7y ago
  > From what I've read it's highly unlikely the dead will be tested. Not only that, but are the Chinese authorities going to accurately report that numbers?
  - n0rbwah 7y ago
    At this point, I'm not sure to see any reason for them to lie about it except for the force of habit.
    - DuskStar 7y ago
      Another reason would be that on a day-to-day basis it's easier to say "yeah we had 100 deaths yesterday" than it is to say "we've been lying, there were 1,000 deaths yesterday and 10,000 so far with 500,000 infected in Wuhan by our estimates". Which would probably also cause a wee bit of panic, too. If that's actually the case, of course.

wyattpeak 7y ago

A lot of discussion seems to highlight the problem of unreported cases, but surely this is a problem for all diseases, not just novel ones. Are there any epidemiologists here to answer how we account for unreported cases of e.g. flu in mortality rates? And if we don't, is it reasonable to ignore unreported cases of coronavirus as well, to compare like with like, or is there some factor I'm missing?

yibg 7y ago
Not an expert here but isn’t there an unknown in the ratio of reported cases too? I doubt it’s safe to assume the percentage of flu cases reported is anywhere close to that of publicized viruses.
Maxion 7y ago
That is correct, though I'm not an epidemiologist. The number is estimated using statistical models, such as SEIR and others. http://www.public.asu.edu/~hnesse/classes/seir.html http://www.public.asu.edu/~hnesse/classes/seir.html

mrtksn 7y ago

Okay, I have been following this closely as I follow JS libraries and this is the headline: The virus seems to require intensive care to some subset of the infected people and deaths occur when that care is not given in timely manner. That means it's mortality rate increases dramatically when your patient care infrastructure gets saturated.

beamatronic 7y ago
Eloquently put. Agree 100%. The logical conclusion then is to ramp up your patient care infrastructure proactively: identity and clear the bottlenecks.
- reagent_finder 7y ago
  Or just cut the budgets.
- FPGAhacker 7y ago
  Agreed. It seems to me there are, in the main, two problems which include many other problems relating to the general problem.
- koheripbal 7y ago
  The bottleneck is the number of mechanical ventilators available. Ideally we want someone on a ventilator to be in an ICU and under a doctor's supervision, but in a crisis you can put a ventilator anywhere. A patient with COVID-19, will likely spend about 2 weeks on a ventilator. Unfortunately, there are only about 60-70,000 mechanical ventilators in the entire US (and maybe double that if you include older less automated ones), and about half of them are for neonatal wards. [source](https://www.ncbi.nlm.nih.gov/pubmed/21149215 https://www.ncbi.nlm.nih.gov/pubmed/21149215). 10% of COVID-19 infections require mechanical ventilation. [source](https://clinicaltrials.gov/ct2/show/record/NCT04244591 https://clinicaltrials.gov/ct2/show/record/NCT04244591). This means that if the US encountered an outbreak on the scale of what is happening in China, then we would also quickly run out of ventilators, and the mortality rate would be 2-4x what it would be otherwise, rather than the 1-2% mortality rate everyone is expecting.

anonsivalley652 7y ago

It's interesting that MERS was about twice as deadly as the Spanish Flu. I guess because it happened in a certain part of the world, the Western media just decided it wasn't worthy of wall-to-wall Snowpocalypse yellow journalism.

dragonwriter 7y ago
Threat from a disease is a combination of tendency to spread, circumstance of initial outbreak, and deadliness. The latter alone isn't what makes it a matter of urgent global concern on a simple pragmatic level.
- anonsivalley652 7y ago
  That's obvious. It's more contagious than Ebola but less so than Norovirus. You're discounting that MERS hasn't gone away... it's sitting in reservoir(s) of wild and/or domesticated animals right now, likely on two continents thanks to travel and clusters of human cases in South Korea as well. If that doesn't worry you, then I guess anticipation isn't your strong suit. The point is: hantavirus was a rare disease but was hyped up in North America, MERS is much worse and has the potential to be a minor Ebola again and again.
occamrazor 7y ago
MERS had apparently a low infectivity, making it a low level threat to the rest of the world.
- anonsivalley652 7y ago
  It's difficult to say that because it was still transmitted to people more easily than Ebola. And the data and research show MERS isn't going away; bats maybe its natural reservoir. Pretending it doesn't exist or not doing anything about is playing Russian roulette with public health. If the US Army Corps of Engineers can eliminate malaria from the southern US, maybe a vaccine can be developed for the natural host and domesticated animals to prevent the risk to humans.

christkv 7y ago

The ongoing nightmare of the cruise ship in japan will provide a worst case unbiased example not tainted by the reliability of Chinese reporting. I just hope that most of them will escape what looks to me like my personal nightmare.

koheripbal 7y ago
Agreed. The quarantined cruise ship is, sadly, an excellent inadvertent experiment for us. It won't help much with the R0 calculation, but it will give us a good idea for mortality, though it might take 3 weeks to get that number.

fxj 7y ago

For "realtime" numbers there is a chinese web-page which shows the mortality rate is of the order 2% and the new infections in Hubei are decreasing. (Google translate is your friend.) https://ncov.dxy.cn/ncovh5/view/pneumonia https://ncov.dxy.cn/ncovh5/view/pneumonia

blackrock 7y ago

The initial death rates were shocking. The reproduction R0 number seemed high. This was a very contagious virus. The world went into a panic. And rumors, conspiracy theories, and bad science didn’t help (the German and Indian papers). But what was really behind the numbers. Was it old people that were dying? Was it middle aged and young people? Was this some kind of stealthy virus that creeps up on you, and then just kills you? It’s possible that it was a lack of medical facilities and equipment, that contributed to the crisis, and thus, contributed to the high initial death rates. For example, when people started getting sick. The first batch went to the ICU, and took up available beds and medical facilities. These people had the highest chance of surviving. But then, the next wave came in and created the beginning of the crisis, and swamped the system. Then, the third wave came in and totally overwhelmed the system, that the hospitals couldn’t help them at all. They were turned away, and left to fend for themselves. These people started dying in their homes. The system suffered such a massive denial of service attack, that it was impossible to help and provide service to everyone. Thus this created the shockingly high mortality rate during the initial days of the crisis. If we are lucky, then this might remain true. So in other parts of the world with more medical facilities, knowing this might save people, and give them a higher chance of surviving this virus. Stay strong, Wuhan! Wuhan, Jaiyou!

jpizagno 7y ago

Does this website not look a little suspicious ? It is hard to find an actual name of a person behind this site. When I go to faq -> "Who .." there is another company called "Dadax" listed, but no link. odd I am asking because people have sent me other suspicious sites over the last few weeks (wuflu.live). I am not denying the virus, just questioning things on the internet.

koheripbal 7y ago
I am loath to use my real name on absolutely anything I put online. ...and frankly, I do not understand people that do. There are crazy people on the internet, and many of them love to hold a grudge.
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